Premium
Steady‐state nevirapine plasma concentrations are influenced by pregnancy
Author(s) -
Nellen JFJB,
Damming M,
Godfried MH,
Boer K,
Van Der Ende ME,
Burger DM,
De Wolf F,
Wit FWNM,
Prins JM
Publication year - 2008
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2008.00551.x
Subject(s) - medicine , nevirapine , pregnancy , plasma concentration , obstetrics , plasma , state (computer science) , human immunodeficiency virus (hiv) , virology , antiretroviral therapy , genetics , viral load , nuclear physics , biology , physics , algorithm , computer science
Objectives Optimal plasma concentrations of antiretroviral drugs are required during pregnancy to treat maternal HIV infection and prevent mother‐to‐child transmission. We investigated the effect of pregnancy on nevirapine (NVP) plasma concentrations. Methods We included all HIV‐1‐infected women for whom NVP plasma concentrations were available as part of routine patient care at two university hospitals. Plasma NVP concentrations were compared for pregnant ( n =45) and non‐pregnant ( n =152) women. Univariate and multivariate linear regression analyses were used to identify and adjust for other confounding factors associated with NVP plasma concentrations. For pregnant women who had a plasma NVP concentration available both during and outside pregnancy, a paired analysis was performed. Results Steady‐state NVP plasma concentrations were lower in pregnant women: 5.2 mg/L (interquartile range 3.9–6.8) vs. 5.8 mg/L (4.3–7.7) ( P =0.08). After adjusting for confounders, both pregnancy (regression coefficient=–0.90 mg/L, P =0.046) and African descent (regression coefficient=+1.13 mg/L, P =0.005) influenced NVP concentrations significantly. The paired analysis showed mean concentrations of 4.8 mg/L during pregnancy and 5.8 mg/L outside pregnancy (paired t ‐test, P =0.073). Conclusions Pregnancy has a moderate but significant lowering effect on NVP plasma concentrations. Being of African descent compensates for the lowering effect of pregnancy on NVP concentrations.